原发性低颅压综合征16例临床分析和影像学特点

Clinical analysis and imaging characteristics of 16 cases of spontaneous intracranial hypotension syndrome

目的探讨原发性低颅压综合征(SIH)的临床特点、发病机制、脑脊液(CSF)及影像学改变。方法回顾性分析16例SIH患者的临床资料。结果16例患者均有体位性头痛;CSF压力均<70mmH2O,细胞数增高2例,蛋白增高9例;16例行头颅CT平扫,11例正常,2例脑肿胀,2例慢性硬膜下血肿,1例硬膜下积液;9例行头颅MRI检查,4例硬脑膜增厚并明显强化,2例慢性硬膜下血肿,1例脑下沉改变。结论认识SIH的临床特点、发病机制、CSF及影像学特征,可提高SIH的确诊率;本病预后一般较好。

Objective To investigate the clinical features, pathogenesis and the changes of cerebrospinal fluid（CSF） and imageology in spontaneons intracranial hypotension（SIH）. Methods The clinical information of sixteen cases of SIH were retrospectively analyzed. Results Among them, all the patients had postural headache and CSF pressure was lower than 70 mmH2O, cell counts were higher than the other patients in two cases, the protein of nine cases increased. In 16 scanned seaned by brain CT, eleven cases were normal, two cases were cerebral swell, two cases had chronic subdural hematoma, one case had subdural collection of fluid. In nine cases by brain MRI, four cases were pachymeningeal thickening and post-contrast enhancement, two patients were chronic subdural hematoma,one patient was ＂sagging＂of the brain. Conclusion The clinical features, pathogenesis and the features of CSF and imageology in SIH conduce to clinical diagnosis ratio. The SIH usually has a good recovery.